Unmet needs of the elderly influenced by social determinants of health (2023)

Unmet needs of the elderly influenced by social determinants of health (1)
  • madison
  • 10. mayo 2022

MeetCaregivers aims to solve the issues facing seniors, families and caregivers by addressing health care inequities and improving access to quality care. This includes raising awareness about the social determinants of health and their impact on aging at the local level. This research article examines five social determinants of health that contribute to the unmet needs of older people and prevent aging in place.

The country's healthcare system has undergone a remarkable transformation as industry focus has shifted toward patient-centered care. This change has been accelerated by the COVID-19 pandemic, which has also exacerbated the unmet needs of vulnerable populations, that is, the elderly.

This change provides new opportunities for collaboration between health care groups to help address the unmet needs of older people. However, as expressed by the National Association of Area Agencies on Aging (n4a) in its statementPolitical Priorities 2019report, success will only come when social and medical institutions prioritize partnership and collaboration.

Collaboration between these groups has grown in the face of the pandemic. Additionally, rising health care costs have led some health professionals to re-examine how the social determinants of health affect seniors and the US health care system.

Understanding the factors that influence our daily lives (whether we are aware of it or not) benefits everyone, especially caregivers of aging loved ones.

What are the social determinants of health?

The Centers for Disease Control and Prevention (CDC)defines the social determinants of healthas "conditions in the places where people live, learn, work, and play that affect a wide range of risks and outcomes for health and quality of life." on the general health and well-being of the population.

The social determinants of health include access to needs such as:

  • Accommodation
  • Food
  • Training
  • social care
  • health care services

Unfortunately, many older people do not have adequate access to housing, nutrition, financial aid, transportation, and social support. These unmet needs are one reason for rising health care costs, particularly for older adults with chronic illnesses or disabilities. But health costs are not the only area affected by this problem. in onePost 2018, the W. K. Kellogg Foundation (WKKF) and Altarum found that differences in health contribute to:

  • $135 billion in economic losses,
  • $93 billion in additional health care costs and
  • $42 billion in lost productivity.

Addressing these factors is critical to promoting sustainable and long-lasting health outcomes for the entire population. Additionally, it eases the financial burden on the federal, state, and local economies, freeing up more resources for programs that help address people's unmet needs.

(Video) Social Determinants of Health

How unmet needs affect aging in place

Most seniors want to age in place, aResearch report 2020found that only 33% of older people surveyed believed they could realistically age instead. According to the researchers, the main barriers that prevent older people from aging include:

  • social barriers
  • access to care
  • Perceived quality of care

In addition, respondents indicated that their main concerns were:

  • Food safety (50%)
  • Health literacy (47%)
  • Home security (46%)
Unmet needs of the elderly influenced by social determinants of health (2)

Social determinants of health such as the above can reduce the probability of aging at home by 7%. Home care services can help, but afragmented care systemprevents many older people from looking for it. As a result, caregiving responsibilities often fall to other family members, with 34% caring for a relative with a chronic illness and 41% being under 38.

A stronger and more cohesive network of care providers is critical for both older people and caregivers. Not only will more people have the resources to age comfortably and safely in place, but it would ease many of the burdens on family caregivers.


Unmet needs of the elderly influenced by social determinants of health (3)

aging in placeIt is attributed to better health, well-being and quality of life outcomes. So it's understandable why90% of older adultsthey would rather grow old in their own home than move to a care facility. However, access to safe and affordable housing prevents many seniors living on low or fixed incomes from aging in the workplace.

For many older Americans, housing is one of the largest monthly expenses. In 2016, residential construction accounted for almost 50%4.9 million income from older adults, while more than1 million older adultsthey lived in low-income housing, which made up 30% of social housing residents.

Access to affordable housing is essential to address the unmet needs of older people, improve health outcomes, and relieve health systems. Unfortunately, high housing costs leave cost-conscious seniors little room in their budgets for essential items like groceries, utilities and medical bills.

A growing body of research underscores the strong link between income and use of health services. for example aStudy 2008Published inMagazine of Community Practiceand a 2017 article published inthe gerontologistfound that low- and even middle-income people are less likely to seek medical help and are more likely to experience poorer health outcomes.


sea ​​aMichigan State University Study, Food insecurity affects 8.9% of older adults living alone, while 3.4% face “very low food insecurity”. In addition, the researchers cited aafter 2015of the Food Research Action Center, who stated:

“Research shows that certain groups of older adults are at higher risk of food insecurity than others. Food insecurity rates tend to be highest among renters who are older, lower income, less educated, black, Hispanic, separated or divorced, single, living in the South (for example, Louisiana, Mississippi, North Carolina, Texas , Alabama). , unemployed, living alone, living with a disability, living with grandchildren, or “younger” older adults (i.e., those ages 50-59).”

Access to healthy foods that meet the dietary needs of older adults is a critical social determinant of health that directly impacts their quality of life. A nutritious and balanced diet plays an important role in the prevention of chronic diseases such as:

  • obesity
  • Diabetes
  • Krebs
  • hypertension
  • cardiovascular disease

Unfortunately, the conditions disproportionately affect people who can't afford healthy ingredients or live in food deserts. Transportation, income and housing are the main barriers for many older people who lack food and demonstrate how the social determinants of health are interconnected and exacerbate significant inequalities.

(Video) What Makes Us Healthy? Understanding the Social Determinants of Health
Unmet needs of the elderly influenced by social determinants of health (4)

Education and health literacy

healthy literatureIt is “the degree to which people are able to find, understand, and use information and services to make health-related decisions and actions for themselves and others” and is the foundation of health and well-being. Yes oneStudy 2003from the US Department of Education found that adults 65 and older had lower health literacy (on average) than younger generations, which likely remains the case nearly 20 years later.

Unmet needs of the elderly influenced by social determinants of health (5)

Unfortunately, those with the least health literacy lack the understanding or resources to make informed health decisions, compounding other unmet needs. Consequently, they often experiencestraightas:

  • Difficulty following treatment programs or a medication routine.
  • Increased pain and decreased physical abilities (which can make it difficult to perform daily activities).
  • Repeated hospitalizations or emergency room visits.
  • Higher medical costs as a result of increased use of emergency services.

These barriers are more likely to affect older adults than other age groups. Therefore, to promote the literacy of this group, experts recommend the implementation of systematic changes such as:

  • Optimize communication between patients and doctors.
  • Minimize misunderstandings by confirming patients' understanding.
  • Help seniors navigate the healthcare system.
  • Supporting older adults trying to improve their health.

social care

Healthy relationships and strong social networks support physical and mental health and functioning.behavioral and psychological pathwaysthat can improve health outcomes. Social support may also indirectly protect against adverse health risks, such as B. alleviating emotional anxiety.

Given the importance of a positive social support system for health, social isolation can lead to poorer health outcomes and even premature death. Loneliness and isolation are particularly problematic for older people, whose social networks often diminish with age.

Isolation and loneliness in the elderly are associated with numerous somatic problems and, therefore, constitute one of the greatest challenges for the health system. If not activated, these states can result in higher rates of:

  • falls
  • heart disease
  • cognitive decline
  • depression and other mental health problems

sea ​​aAARP 2017 Notice, 14% of seniors experienced isolation, but it accounted for $6.7 billion in additional federal spending. The pandemic has only made this problem worse, with asurvey 202061% of adults over the age of 50 consider themselves socially isolated.

The lack of federal and state preventative measures is particularly detrimental to older people in rural communities, where unmet needs, such as a lack of transportation, only exacerbate isolation. Furthermore, the social supports that support the health of older people vary significantly and sometimes require collaboration across sectors (education, housing, public health) to improve community and improve individual well-being.

access to health

Unmet needs of the elderly influenced by social determinants of health (6)

Limited access to health services is another factor contributing to the unmet needs of older people and poorer health outcomes. This problem is caused in part by the economic uncertainty that affects more than15 million older adultsin the US Within this group, 50% get most of their income from social security.

Aafter 2008found that "poor adults are almost five times more likely than wealthy adults to report poor or fair health." Whether due to cost, a limited provider network, or other reasons, underinsured and uninsured adults are less likely to seek the treatment they need, when they need it. This creates health expenses for seniors who were previously uninsured51% higherthan for the previously insured.

Policies like the Affordable Care Act (ACA) have helped contain rising health care costs for older adults and have increased the availability of health care services for underinsured older adults. or without insurance.

(Video) “Digital” Determinants of Health | Rachael Donalds | TEDxNewBedford

These guidelines are also critical for federal spending, which exceeded $702 billion in 2017, or nearly 15% of the total Medicare budget. And in 2019, one in six older adults (approximately 60 million) had insurance coverage. But as the number of seniors eligible for Medicare increases, so does the cost, and some experts expect spending to exceed this1 trillion dollarsuntil 2026.

HeUS Senior RateIt's not the only factor contributing to Medicare increases. To some extent, the social determinants of health are also responsible for contributing to the unmet needs of older people. For example, Medicare is designed to help offset the acute costs of hospital care. However, in the past it has refused to pay for many preventative measures that might prevent the need for hospital care in the first place. And while lawmakers expanded Medicare benefits to support independence and health, including home care, many still receive limited support.

Additionally, some CMS state agencies have considered repealing or reducing regulations, such as non-emergency medical transportation (NEMT) services. The measure would also increase costs, since coverage of services like NEMT is critical to promoting the well-being and independence of older people. according to aStudy 2018of the Medical Transportation Access Coalition (MTAC), NEMT "saves Medicaid, and therefore taxpayers, more than $40 million per month for every 30,000 beneficiaries treated for any of the three conditions addressed in the study" .

for almost66% of Medicare beneficiariesWith multiple chronic conditions, transportation assistance helps them keep routine medical appointments and receive the care they need, preventing minor problems from becoming costly expenses. The removal of such benefits impedes seniors' access to preventive care, further increasing costs for Medicaid recipients, payers, and payers.

Age discrimination contributes to the unmet needs of older people

The World Health Organization (WHO) defines age discrimination as “stereotypes, prejudices and discrimination against people because of their age”. Age discrimination occurs in institutional settings, in everyday interactions, or even within individuals. In his year 2021World report on age discrimination, the WHO noted that the pandemic highlighted age discrimination in several areas, such as:

  • Differences in access to health care
  • Media stereotypes alienate generations
  • Inadequate measures to protect the elderly in nursing homes

Age discrimination is often overlooked as a social determinant of health, despite known disadvantages for older adults, such as:

  • shorter shelf life
  • Faster rates of cognitive decline
  • Decreased physical and mental health.
  • Increased risk of social isolation and loneliness.
  • Slower recovery from illness or disability
  • Less access to employment, education and health care.
Unmet needs of the elderly influenced by social determinants of health (7)

AndA studyfound that age discrimination costs seniors age 60 and older an additional $63 billion (or $1 for every $7) in health care each year. But ageism doesn't just affect individuals; the consequences extend to communities, states, economies and health systems. The far-reaching ripple effects underscore the importance of removing the factors that help ageism persist. But the multifaceted nature of ageism also makes it harder to combat. In response, the WHO offers three methods to stop age discrimination:

  • Engage in positive intergenerational activities on a regular basis.
  • Combat discrimination and inequality based on age with policies and laws that defend human rights.
  • Change misconceptions, accurate information, and conflicting stereotypes by breaking down barriers at all levels of education.

By implementing the above strategies, policymakers and leaders at all levels will help reduce age discrimination while addressing a critical societal decline in health and addressing the unmet needs of older people.

(Video) Social Determinants of Health

MeetCaregivers helps address the unmet needs of seniors

Most older people want to stay at home, but they don't always have the means to do so. We support aging in place by reducing factors that contribute to the unmet needs of older people, such as:

  • support independence
  • Coping with chronic diseases
  • Reduce loneliness and isolation.
  • Improve access to care

Our solutions also support caregivers with practical home care resources including training, home health providers, and technology tools such as:

  • OurCare Matching Algorithmimproves the match between seniors and caregivers, reduces caregiver turnover by 80%, and increases the satisfaction rate of caregivers, seniors, and families by 90%.
  • HeFamily Care Portalallows caregivers, families, seniors, healthcare providers, and carriers to easily connect and track care plans, tasks, activities of daily living, medications, and health data through a single application.
  • Ourhome care marketoffers additional products to help seniors at home, such as B. Continence, mobility and accessibility products.

To see how we can help, give us a call.1 (888) 541-1136or email info@meetcaregivers.com to schedule a meeting with a care coordinator. You also can visitFind a sitterto find help today.

For more resources and information on caregiving and aging locally, visit ourThe blog.

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